Role of Macrophages in Pregnancy and Related Complications

  • Manoj K. JenaEmail author
  • Neha Nayak
  • Kang Chen
  • Nihar R. Nayak


Macrophages (MФs) are the leukocytes produced from differentiation of monocytes and are located in almost all tissues of human body. They are involved in various processes, such as phagocytosis, innate and adaptive immunity, proinflammatory (M1) and anti-inflammatory (M2) activity, depending on the tissue microenvironment. They play a crucial role in pregnancy, and their dysfunction or alteration of polarity is involved in pregnancy disorders, like preeclampsia, recurrent spontaneous abortion, infertility, intrauterine growth restriction, and preterm labor. About 50–60% of decidual leukocytes are natural killer (NK) cells followed by MФs (the second largest population). MФs are actively involved in trophoblast invasion, tissue and vascular remodeling during early pregnancy, besides their role as major antigen-presenting cells in the decidua. These cells have different phenotypes and polarities in different stages of pregnancy. They have also been observed to enhance tumor growth by their anti-inflammatory activity (M2 type) and prevent immunogenic rejection. Targeted alteration of polarity (M1–M2 or vice versa) could be a major focus in the future treatment of pregnancy complications. This review is focused on the role of MФs in pregnancy, their involvement in pregnancy disorders, and decidual MФs as possible therapeutic targets for the treatment of pregnancy complications.


Macrophage Human pregnancy Decidualization Polarity VEGF Preeclampsia 



We thank Matt Petitt, PhD, for his comments and editorial assistance in preparation of the manuscript.

Author Contributions

MKJ wrote the manuscript, NN reviewed and edited the manuscript, KC conceptualized, reviewed and edited the manuscript, NRN conceptualized, reviewed, edited, and provided the funds required for completing the manuscript.


The present work was supported by the NICHD award number R01HD088549 to Dr. Nihar R Nayak.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.


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Copyright information

© L. Hirszfeld Institute of Immunology and Experimental Therapy, Wroclaw, Poland 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyWayne State UniversityDetroitUSA
  2. 2.Department of Biotechnology, School of Bioengineering and BiosciencesLovely Professional University (LPU)PhagwaraIndia

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